Angina aka Chest pain

• Chest pain can be described as pressure, squeezing, tightness or fullness in the neck, chest, left shoulder, jaw, epigastric and back,,
• Types of Angina

  • Prinzmetal: coronary vasospasm that happens whether a person is at rest or doing an activity
  • Microvascular: affects small branches of the coronary artery
  • Chronic Stable: occurs with activity or emotional stress.
  • Unstable: rupture due to the vessel being closed off
• Diagnosis of Angina

  • Troponin T: peaks at 12 hours and lasts for 10-14 hours. Tells us that there is damage to the heart
  • CRP: a marker for inflammation
  • Homocysteine: elevated levels increase risk of angina
  • CXR
  • CT scan
  • Lipoprotein
• Care for Patients with Angina

  • Rest, position upright
  • Give oxygen
  • Get 12 lead ECG
  • Get cardiac biomarker (Troponin T)
  • Give meds (NTG, opioids (IV), chewable aspirin
  • DO NOT GIVE ISOSORBIDE MONONITRATE IF SBP is <100
• In unstable angina, a person must have STEMI so give thrombolytics within 30 mins to 12 hours
• Do not give a thrombolytic if the patient's BP is >180/110
• When giving patient anticoagulants, check PTT for heparin and PT and INR for warfarin first
• Tell patient to call 911 if they have a weight gain of 3lbs in 1 week and SOB, wheezing,